The goal of this 30-minute podcast is to prepare disaster behavioral health (DBH) responders and their family members for deployment by reviewing pre- and post-deployment guidelines and ways to prepare for the stress of deployment and reintegration into their regular work and family lives.

Provide pre-deployment guidelines to assist DBH responders and their family members as they prepare for deployment.

Provide post-deployment guidelines and practices that enable reintegration with family members and routine employment.

The featured speaker is April Naturale, Ph.D., of the SAMHSA Disaster Technical Assistance Center (DTAC). Dr. Naturale is a traumatic stress specialist with 25 years of experience in health/mental health administration. She directed New York's disaster mental health response following the terrorist attacks of 9/11. Dr. Naturale also spent several years in the Gulf Coast after large-scale hurricanes devastated the area.

SAMHSA DTAC encourages participation by behavioral health, public health, and other professionals involved in emergency management and disaster response.

If you have questions or need additional information, please contact Lori McGee at 240-515-8414 or lori.mcgee@icfi.com. We would appreciate your thoughts on this podcast or suggestions for future podcasts/webinars. Please send feedback to dtac@samhsa.hhs.gov

National Survey Shows Reduction in Non-Medical Prescription Drug Use Among Young Adults

Report also shows reductions in binge and heavy drinking among underage youth.

The number of people aged 18 to 25 who used prescription drugs for non-medical purposes in the past month declined 14 percent—from 2.0 million in 2010 to 1.7 million in 2011—the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) announced today, during the 23rd annual national observance of National Recovery Month. Non-medical use of prescription drugs among children aged 12 to 17 and adults aged 26 or older remained unchanged.

In addition, the 2011 National Survey on Drug Use and Health (NSDUH), a survey conducted annually by SAMHSA, showed that the rates of past-month drinking, binge drinking and heavy drinking among underage people continued a decline from 2002. Past-month alcohol use among 12- to 20-year-olds declined from 28.8 percent in 2002 to 25.1 percent in 2011, while binge drinking (consuming 5 or more drinks on a single occasion on at least 1 day in the past 30 days) declined from 19.3 percent in 2002 to 15.8 percent in 2011, and heavy drinking declined from 6.2 percent in 2002 to 4.4 percent in 2011.

Overall, the use of illicit drugs among Americans aged 12 and older remained stable since the last survey in 2010. The NSDUH shows that 22.5 million Americans aged 12 or older were current (past month) illicit drug users—(8.7 percent of the population 12 and older in 2011 versus 8.9 percent in 2010).

NSDUH is an annual nationwide survey of approximately 70,000 people age 12 and older. Because of its statistical power, it is the Nation's premier source of statistical information on the scope and nature of many substance abuse and mental health issues affecting the Nation.

National Recovery Month (Recovery Month) is a national observance that recognizes the accomplishments of people in recovery from mental and substance use disorders and the contributions of treatment providers. Recovery Month activities nationwide spread the positive message that behavioral health is essential to overall health, prevention works, treatment is effective, and people can and do recover.

For patients who have undergone major orthopedic surgery such as hip or knee replacement, extending post-surgery use of medications, from the standard 7-10 days to 28 days or longer, to prevent blood clots may be beneficial, according to a new AHRQ Effective Health Care Program review. While there is not enough evidence to determine which type of anti-clotting medication is best, within the heparin class of medications, low molecular-weight heparin was found to be superior to unfractioned heparin. More research, particularly clinical trials, is needed to compare the effectiveness of using single or combination therapies, including medications or mechanical prophylaxis, such as leg compression or foot pumps and to evaluate the use of medications after less serious types of orthopedic surgery. Select to access the review, Venous Thromboembolism Prophylaxis in Orthopedic Surgery.

Pump and Glucose Monitoring Improve Diabetes Management

Sensor-augmented insulin pumps (intensive insulin therapy combined with real time continuous glucose-blood sugar monitoring) are superior to multiple daily insulin injections and self-monitoring of blood glucose (fingersticks) to lower hemoglobin A1c (the preferred method of assessing blood sugar control in the blood) in patients with type 1 diabetes, a new review from AHRQ’s Effective Health Care Program has found. The review found an improved quality of life of patients who are using insulin intensive therapies and real time self-monitoring of glucose (sensors attached to the body that continuously measure blood sugar). Generally, additional research should focus on standardizing treatment goals and evaluating the effectiveness of insulin delivery methods and glucose monitoring technologies in different patient populations. These findings and future research needs are summarized in Methods of Insulin Delivery and Glucose Monitoring: A Comparative Effectiveness Review.

New Research Review on Methods to Diagnosis Plasma Cancers

A new research review from AHRQ’s Effective Health Care Program found there may not be sufficient evidence to determine whether the addition of the Serum Free Light Chain (SFLC) investigative procedure to traditional testing increases diagnostic accuracy for Plasma Cell Dyscrasias (PCD, a cancer of the plasma cells) or whether it helps predict disease progression. Although the SFLC procedure has been in use for a decade for PCD diagnosis, how best to incorporate it into practice remain unclear. The review, Serum-Free Light Chain Analysis for the Diagnosis, Management, and Prognosis of Plasma Cell Dyscrasias, determined that the evidence was mostly insufficient as to what extent adding SFLC to current tests improves diagnosis, prognosis, monitoring of therapy, and treatment decisions. The review found that more research is needed to understand the exact role of SFLC and the most effective use of the procedure across the full range of PCD cancers and clinical settings.

Formats

Breathing Retraining Techniques May Help Adult Asthma

A new evidence-based review from AHRQ’s Effective Health Care Program finds that complementary breathing retraining methods such as hyperventilation (over-breathing) reduction breathing, when compared to other breathing techniques, may reduce asthma symptoms and may decrease use of quick relief medications. Only minor harms were reported in these studies.Patients considering intensive asthma-focused training should not change their use of asthma medication without consulting with their medical provider. Select to access the research review, Comparative Effectiveness of Breathing Exercises and/or Retraining Techniques in the Treatment of Asthma.

Source

Abstract

BACKGROUND & AIMS:

Ambulatory reflux testing is used to evaluate symptoms of gastroesophageal reflux disease (GERD) refractory to protein pump inhibitors (PPIs). We investigated the prevalence of PPI use in patients with negative results from Bravo pH or multichannel intraluminal impedance-pH (MII-pH) tests and factors that might predict the use of PPIs.

METHODS:

We analyzed data from patients who had undergone Bravo pH monitoring or MII-pH testing at Northwestern University, without evidence of reflux disease. Demographics, endoscopy findings, pathology results, and provider recommendations were obtained via chart review. Eligible patients (n = 90) were contacted by telephone, and a cross-sectional survey was administered with questions about symptom severity, demographics, medication use, and health behaviors. Patients were compared by current PPI use, and statistical analyses were performed by using SAS version 9.2 software.

RESULTS:

Thirty-eight patients (42.2%) reported current PPI use despite a negative result from a pH study. Only 17 patients (18.9%) recalled being instructed to stop taking PPIs; chart review showed documented instructions to stop PPI therapy for 15 patients (16.7%). There were no significant differences in demographic or clinical characteristics among patients compared by current PPI use. Patients taking a PPI were more likely than those not taking a PPI to report troublesome symptoms that affected their daily life, as measured by a questionnaire for the diagnosis of GERD (the GerdQ).